Cooper added that the problem is particularly difficult to confront because the underlying issue is that many black men who have sex with men simply don't consider themselves Gay. Thus, they tune out HIV prevention messages about anal sex and don't consider themselves at risk to contract the disease from sex with a man. Cooper said the real solution to rising HIV infection rates among straight black women is empowering black women to demand their sexual partners use condoms.



National: CDC: Gay, bi men driving epidemic Black community's risk nearly tenfold

The Washington Blade - September 3, 1999
Kai Wright


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New infections among black Gay and bisexual men are largely responsible for driving the AIDS epidemic in the black community in the United States ù an epidemic in which African Americans are nearly 10 times as likely to contract HIV as white Americans ù according to data released this week.
The U.S. Centers for Disease Control and Prevention cited new studies showing that black Gay male youth are more than five times as likely to contract HIV as other Gay male youth. And, citing studies that show high numbers of black men having unsafe sex with both men and women, the agency said that HIV infection among bisexual black men is increasing infection rates among heterosexual black women.

A CDC spokesperson noted that the agency has a new testing system to distinguish infections that are "new" (meaning they were acquired within the last four to six months) ù thus enabling public health officials to more easily identify how and from whom it was transmitted. But the agency was unable to provide the Blade with data showing the percentage of new infections within the overall black community that could be ascribed to men having sex with men. CDC said the system is not yet developed enough to allow statistical analysis across categories and modes of infection.

However, one indicator of new infections among black Gays, suggested CDC officials, can be discerned by considering the cumulative data on HIV infections in the 13 to 24 age group. Using CDC data gathered from the 25 states that currently conduct HIV reporting, CDC officials told the Blade that about 40 percent of all HIV infections among this age group to date are black males who have sex with males. Given that these infections are among young people and are HIV rather than AIDS cases, the CDC believes they provide a reflection of how many black Gays are becoming newly infected.

The CDC unveiled the new data at an HIV prevention conference in Atlanta held Aug. 29-31. The conference, CDC organizers said, was intended to combat "a growing complacency" about HIV prevention nationwide.

In addition to the studies showing the continued disproportionate impact of AIDS on the black community, CDC highlighted studies that show AIDS continues to threaten Gay and bisexual men in general. One such study ù a six-city survey of 96,000 STD clinic clients, led by CDC researcher Hillard Weinstock between 1991 and 1997 ù found that 8 percent of Gay and bisexual men were infected compared to 0.48 percent of their heterosexual counterparts. In another study, CDC found 7 percent of Gay and bisexual youth tested in public venues in seven cities tested positive for HIV infection. Many of the youth reportedly learned of their HIV status only after participating in the survey. The same study found that 3 percent of the overall Gay and bisexual youth tested were infected in the previous four to six months.

"Few of the HIV-positive men we found knew they were infected before we tested them, even though many had had an HIV test in the past year," lead researcher Linda Valleroy said, in unveiling the results of the young Gay male study, according to a Reuters report. The study also found that 41 percent of the Gay youth had unprotected anal sex in the past six months.

The CDC publicized numbers that showed that the dramatic decline in overall AIDS deaths seen in the mid-1990s has slowed just as dramatically since 1997. After a 42 percent decline in AIDS deaths between 1996 and 1997, deaths dropped just 20 percent between 1997 and 1998, according to CDC data. Similarly, the declining rate of infection has slowed as well. The HIV infection rate dropped 18 percent between 1996 and 1997, but only 11 percent between 1997 and 1998.

But amid all the sobering new data, the conference's most startling statistics were those showing the upward-spiraling epidemic within the black community ù Gay and straight.

At an Aug. 30 press conference, only briefly reported in the mainstream press, CDC director of HIV prevention Dr. Helene Gayle and National Association of People With AIDS head Cornelius Baker officially unveiled the results of several new studies offering more detail than was previously available about AIDS in the black community. Gayle opened the press conference by noting that African Americans account for nearly half of both AIDS deaths and new AIDS cases in 1998 ù despite representing only around 13 percent of the national population. She then asked Baker to "paint the full picture of who's at greatest risk."

Characterizing the AIDS epidemic as "one of the worst catastrophes we've seen [in the black community] since slavery," Baker singled out black Gay and bisexual men as a primary at-risk group. He tied the high prevalence of AIDS in the black Gay and bisexual male community to the virus's spread throughout the larger black community. Baker, a longtime black Gay and AIDS activist, cited three studies in particular as showing greater risk among black Gay men than other populations:

* David Webb of the Sacramento Department of Health Services surveyed 2,638 Gay males between the ages of 13 and 19 who took HIV tests at California state-funded clinics between 1995 and 1997. He found black participants were 5.8 times more likely to be HIV positive than white participants were,

* Valleroy's seven-city study, surveying Gay and bisexual men between the ages of 15 and 22, found that black participants were almost five times as likely to be infected with HIV as white participants. Fourteen percent of the black participants and 13 percent of the mixed-race participants tested HIV positive, compared to only 3 percent of the white participants. Seven percent of Latino participants tested positive. Valleroy's team surveyed 3,492 young Gay and bisexual men in public venues between 1994 and 1998 in New York City, Baltimore, Dallas, Los Angeles, Miami, San Francisco, and Seattle;

* Weinstock's six-city study, in addition to finding Gay and bisexual men overall to be 17 times more likely than straight men to contract HIV, also found black Gay and bisexual men are almost twice as likely to contract new infections as their white counterparts. Using a groundbreaking new testing technology that allows researchers to distinguish whether or not an infection was initiated in the previous four to six months, CDC researchers reviewed blood samples of 96,000 clients of STD clinics in Baltimore, Miami, New Orleans, Houston, Denver, and Los Angeles. Eleven percent of the African Americans were new infections, compared to 6.5 percent for whites and 7.7 percent for Latinos.

"It shows," Baker said of the studies, "where we still have tremendous challenges."

He and Gayle went on to tie two new studies discussing bisexuality and HIV in the black community to increasing rates of infection among heterosexual black women. One study, conducted by New York City Department of Health and the Gay Men's Health Crisis, surveyed 7,065 men in Gay venues in New York and found 20 percent of black men reported having sex with both men and women, compared to 12 percent of Latino men, and 4 percent of white men. The second study, conducted by the Michigan Department of Community Health, surveyed 1,001 HIV-positive black men in southeast Michigan and found that 36 percent of the men who reported having sex with men also reported having sex with women.

Both Baker and Gayle said the data on HIV prevalence among black men who have sex with men combined with that on higher rates of bisexuality among black men lends greater credence to the theory that steadily rising rates of HIV infection among heterosexual black women who are not injection drug users is tied to men having unprotected sex with men as well as women. Gayle said 64 percent of new infections among women in 1998 were African Americans.

"You get the sense that there's a lot more [men who have unprotected sex with men and women] à than we have previously documented," Gayle commented. Both Gayle and Baker said prevention efforts must be tailored to meet this phenomenon.

Black Gay and AIDS activist Mario Cooper said he was not surprised by any of the statistics unveiled this week. He said the fact that black men are having unsafe sex with both men and women and, subsequently, are driving up HIV infection rates among straight black women is "a practical reality that we've got to figure out how to address."

Cooper added that the problem is particularly difficult to confront because the underlying issue is that many black men who have sex with men simply don't consider themselves Gay. Thus, they tune out HIV prevention messages about anal sex and don't consider themselves at risk to contract the disease from sex with a man. Cooper said the real solution to rising HIV infection rates among straight black women is empowering black women to demand their sexual partners use condoms.